Newborn OHIP - Residency- 153 of 183 days Question

Currently, the application form for newborn child at the hospital states that, the child must be present in Ontario for 153 days in the first 183 days. i.e the absence cannot be greater than 30 days in the first 183 days. While the legislation states 1.5 (1).(1) (iii), that the child is exempt.

1.5 (1) The following requirements must be met for a person to be continued to be recognized as a resident:1. The person must be in Ontario for at least 153 of the first 183 days after becoming a resident, except for,i. a person who has moved to Ontario directly from another province or territory of Canada where he or she was insured under a publicly funded health care insurance plan,ii. a mobile student or a mobile worker,iii. a child to whom section 6 applies, oriv. a person who is exempt from the waiting period under subsection 11 (2.1) of the Act.2. Except for those persons listed in subsection 1.3 (2), the person must continue to maintain his or her primary place of residence in Ontario. 3. Subject to sections 1.6 to 1.14, the person must be physically present in Ontario for at least 153 days in any given 12-month period. 4. The person must continue to hold an eligible status as listed in section 1.4. However, in order to maintain their eligible status as a resident, a person referred to in paragraph 13 of section 1.4 must be legally entitled to remain in Canada and will only maintain their eligible status under that paragraph as long as reasonable efforts are being made for the person to obtain one of the other eligible statuses under section 1.4. O. Reg. 133/09, s. 2.6. (1) A newborn, who, on the date of his or her birth, meets the requirements to be a resident is exempt from the three-month waiting period for the three months immediately following the date of birth.

The Ministry of Health is also taking measures to ensure access to medically necessary services to uninsured individuals to address the COVID-19 outbreak. According to this notice on the Association for Ontario Midwives website,

the Ministry [of Health] requests hospitals provide all medically necessary services to all persons who present at a hospital, regardless of whether the person presents a valid OHIP card, or does not have health insurance under OHIP or another provincial health insurance plan.

This means that everyone, insured and uninsured, will receive medically necessary care.

Tourists, transients or visitors are not eligible for OHIP coverage. For a child born in Ontario to be eligible for Ontario health insurance coverage they must make their primary place of residence in Ontario, and be physically present in Ontario for at least 153 days in any 12-month period to retain OHIP coverage.

If you are visiting Ontario from another province or territory in Canada, contact your home province/territory regarding health insurance coverage for your baby and any insured services received while visiting Ontario.

Babies born in Ontario are immediately eligible for OHIP coverage if you live in Ontario. However, tourists, transients or visitors are not eligible for OHIP coverage. For a child born in Ontario to be eligible for Ontario health insurance coverage they must make their primary place of residence in Ontario, and be physically present in Ontario for at least 153 days in any 12-month period to retain OHIP coverage.

If you are visiting Ontario from another province or territory in Canada, contact your home province/territory regarding health insurance coverage for your baby and any insured services received while visiting Ontario.